Benefits and risks of herbal products in pregnancy

Mohamed Ahmed Mahmoud Khalifa 2007 / 1176

Herbal medicine PHG 431

Dr. Khaled Meselhy

Spring 2011

Final draft

Herbal medicine is the use of herbs to treat diseases. Herbal medicine is the first kind of

medicine used by humans. All cultures used herbs throughout history. Plants served as food,

clothing, shelter and medicine. Ancient people explored the plants surrounding them. They used

to observe wild animals and began to depend on trial and error to know the effects of plants.

Later on, they developed herbal pharmacopoeias. Many people today use herbal drugs. About

25% of drugs prescribed in United States contain at least one active constituent from plant

extract. Herbs are used mainly for four purposes, which are food, cosmetics, health and

medicine. Herbs can be used in pregnancy. Many women used to administer herbal medicines in

pregnancy and menstrual disorders. Herbal medicine is used to treat many diseases associated

with pregnancy such as morning sickness, threatened miscarriage, difficult labour and poor milk

production. Pregnancy is the most wonderful dream for each woman. Women use to search for

the best health care for themselves and for their fetuses. Many pregnant women believe that

herbal medicines are the best choice for their health care. Some pregnant women like to use

herbal products because of their efficacy and safety; whereas, others believe that herbal drugs

cause harmful consequences and have low safety.

Many pregnant women prefer to use herbs due to their high efficacy in treating many

diseases. They can treat menstrual disorders. They treat menstrual irregularity; herbs are used to

treat pain associated with menstruation and to treat irregular menstrual periods. Chaste tree

(Vitex agnus-castus) is a good example for treating menstrual irregularity. Although studies and

clinical trials are limited but it has proven efficiency in treating this disease. This herb works on

hypothalamic and pituitary hormone production. Another disease is the premenstrual tension. It

is treated by a standard therapy which is the standard herbal anxiolytic/antidepressant St John’s

wort and valerian (Valeriana officinalis). Therapy can be complemented with diuretics as

dandelion (Taraxacum officinale). Other useful herbs are hyperium, chaste tree and vitex.

Evening primrose oil also recommended though no studies confirming effectiveness in

premenstrual syndrome. It also may treat cyclical mastalgia but there is no enough evidence.

Amenorrhoea is one of the complications that are treated by herbal medicine. The use of

emmenagogue is suitable in this situation. Black cohosh (Cimicifuga racemosa) and blue cohosh

(Caulophyllum thalictroides). In the past, people used to use chaste tree to treat infertility. Chaste

tree also was used to induce breast milk flow after birth though it lowers prolactin levels. Red

raspberry (Rubus idaeus) is benefit in all situations of pregnancy and labour management

although must be avoided in the first trimester. It has been used for a long time due to its

prevention of miscarriage. Nettle (Urtica dioica) and dandelion are used as nutritional

supplements but they lack enough evidence of effectiveness. Morning sickness is not treated by

the conventional drugs because the use of anti-emetics is restricted in the first trimester. Since, it

is the period of major organ formation. So, the herbal alternative therapy is used. Ginger

(Zingeber officinale) is the most commonly used but in large doses it may cause miscarriage. In

the internet journal “Alternative Therapies in Health and Medicine” Bruce Barett, David Kiefer

and David Rabago demonstrate that although ginger can treat nausea and vomiting during

pregnancy, its recommendations for use are not clear due to its unknown safety.

Chaste tree (Vitex agnus-castus) is one of the most commonly used herbs in gynaecology

and obstetrics. It is used in miscarriage and many other indications. In the book “Herbal

Medicine”, Rudolf Fritz Weiss and Volker Fintelmann say “Vitex agnus-castus is mainly used

for treatment of premenstrual syndrome, mastodynia, and menstrual abnormalities”. Castor oil

(Ricinus communis) is used as bowel stimulant and is used to stimulate uterine contractions. So,

it is used to manage labour. Raspberry leaf and squaw vine are used for preparation of uterus for

delivery. Black cohosh and goldenseal (Hydrastis Canadensis) have the ability to stimulate the

uterus. The most commonly used herbs in labour are evening primrose, red raspberry, castor oil.

Ergot (Claviceps purpurea) is a fungus and ergometrine is a derivative of it. They are used to

cause uterine contraction and decrease post- partum bleeding. Breast feeding is very important

for the baby so we use many herbs to stimulate milk flow. Some of them are the cabbage tree

(Cordyline australis), fenugreek (Trigonella foenum-graecum) and peppermint (Mentha piperita).

In the book “Herbal Medicine” Graham Pinn states that one of the most common uses of

herbal medicine is the treatment of menopausal symptoms. Many women complain from

menopausal symptoms. Phyto-oestrogens, mild sedatives and oestrogen substitutes are used in

this case. Black cohosh (Cimicifuga racemosa) suppresses luteinizing hormone production or it

works by some oestrogenic activity. It is confirmed by the German E Commission for treatment

of premenstrual syndrome, dysmenorrhoea and menopausal symptoms. The studies illustrated

that it is safe, effective and can be alternative for oestrogen therapy. In addition to black cohosh

dysmenorrhoea can also be treated by chamomile. In the book “Weiss’s Herbal Medicine”,

Rudolf Fritz Weiss denotes “In practice, it will always be best to start with chamomile and only

change to more powerful drugs if the effect is not adequate”.

Some pregnant women are against herbal drugs because of their harmful effects. For

example, angelica herb and lovage roots cause uterine contraction so they are contraindicated

with pregnant women. Cinchona bark cannot be used during pregnancy as it contains many

alkaloids which are harmful during pregnancy. Eucalyptus flower cannot be eliminated from the

kidney so it is not preferable for pregnant women. Ephedra herb acts as stimulant and increase

blood pressure so its prohibited during pregnancy. Mistletoe causes contractions so it is avoided

while pregnant. Pennyroyal has high concentration so it should not taken internally. In addition,

it is toxic in nature and leads to miscarriage. Besides, poke root contains alkaloids harmful for

human’s health. It causes vomiting and results in cramps and watery diarrhea. Moreover, rue

produce stomach cramps and vomiting and not recommended for use by pregnant women.

In conclusion, every pregnant woman should take care before taking any herb. Most of

herbs are harmful for pregnant women. She must ask her health care provider about each

medication before use. She must be aware of the risk/benefit ratio of each drug. Being natural

does not mean safe so each woman should ensure safety and follow instructions for correct use

of products. Take care of correct dose and duration of drugs or other with toxicity may occur.

Don’t rely on internet or media sources but rely upon a certified herbalist or a health care

provider. There should be health awareness for medical staff in hospitals to avoid hazardous

misuse of drugs. There must be health awareness for the community through media, commercials

and community pharmacies. Finally, each pregnant woman should think hundred times before

administering any drug.

Works Cited

Barrett, Bruce, David Kiefer, and David Rabago. “Assessing the Risks and Benefits of Herbal

Medicine: An Overview of Scientific Evidence”. Alternative Therapies in Health and

Medicine. Vol. 5(4). (Jul. 1999): 40 – 9.

Pinn, Graham “Herbal Medicine in Obstetrics and Gynaecology”. Herbal Medicine. 1st ed.

Blackwell, 2003. 42 - 53.

Weiss, Rudolf Fritz, and Volker Fintelmann. “Gynecological Disease”. Herbal Medicine. 2nd ed.

Stuttgart: Thieme, 2000. 325 – 41.

Weiss, Rudolf Fritz “Gynaecological Conditions and Diseases of the Breast”. Weiss’s Herbal

Medicine. 6th ed. Stuttgart: Thieme, 2001. 307 – 21.